title: Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study.
abstract: BACKGROUND
  Trocar site incisional hernia (TSIH) is a common complication after laparoscopic cholecystectomy. The aim of this study was to evaluate the prevalence of TSIH and analyze the influence of several risk factors for this complication in a prospective series.
  
  
  METHODS
  From 2007 to 2008, a prospective observational study with 3 years of follow-up was performed including all consecutive patients with cholelithiasis who underwent elective laparoscopic cholecystectomy. A multivariate analysis was performed to identify risk factors for TSIH.
  
  
  RESULTS
  Overall, 241 patients were included. During a median follow-up period of 46.8 months, 57 patients (25.9%) were diagnosed with umbilical TSIH by physical exam or ultrasound. The multivariate analysis revealed that incision enlargement (odds ratio [OR], 14.17; 95% confidence interval [CI], 3.61 to 55.51; P < .001), wound infection (OR, 5.62; 95% CI, 2.35 to 13.42; P < .001), diabetes mellitus (OR, 2.79; 95% CI, 1.05 to 7.37; P = .0038), and obesity (OR, 2.71; 95% CI, 1.28 to 5.75; P = .009) contributed to the risk for developing a TSIH.
  
  
  CONCLUSIONS
  Umbilical TSIH is highly prevalent. This study identified several factors that could be useful to introduce preventive measures in high-risk patients.
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Comajuncosas
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Judit
authors.initials: J
authors.lastname: Hermoso
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Gris
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Jimeno
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Rolando
authors.initials: R
authors.lastname: Orbeal
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Vallverdú
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: López Negre
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Urgellés
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Estalella
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain. Electronic address: david.pares@pssjd.org.
authors.forename: David
authors.initials: D
authors.lastname: Parés
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013525:Surgical Instruments / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000150:complications / Q000453:epidemiology
keywords: Complications; Incisional hernia; Laparoscopic cholecystectomy; Risk factors; Trocar site